ANTONIO LAMONT CLARK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049119765

License Status

NOT RENEWED

Business

First Name

ANTONIO

Middle

LAMONT

Last Name

CLARK

Business Name

ANTONIO LAMONT CLARK

Original Issue Date

01/08/1998

Effective Date

01/08/1998

Expiration Date

03/31/1999

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

10/17/2005